Choked Pipes

"This is the first book of its kind. Sania Nishtar has her own NGO thinktank, Heartfile , which is just focused on healthcare reform. She makes the case in the book that healthcare is a basic right of every citizen. It has to be seen as a fundamental right, and the state should be held responsible if it is not working properly. Then she gets into the details of how the public and private sector can work together. Today in Pakistan, if you’re in Islamabad or Lahore, or any major urban centre, you will find some top class hospitals. These have physicians with foreign degrees, with professional experience in the US and the UK. There is competitive post-surgery care, and they are generally well managed. But you need to be a very rich person to be able to even enter that hospital. Then there are the public hospitals. You pay a minimum price, maybe even less than $10 to go there. But these hospitals are in very bad shape. There are too many people, too few hospitals, so there are long lines, and the quality of healthcare you get is really very poor. You can even catch a new disease by going there. She argues that the private sector can do a lot, because they’ve already invested. The Pakistani elite, those who have access to money and to resources, have been able to establish a healthcare system that works for them. But for 95% of the people, the state has done almost nothing. She tries to show how reform can go forward in a step-by-step fashion, what the state can do. She is not someone who is just making a general hypothetical case, that ‘Yes! We want healthcare for everyone!’ She is providing all the details, the status of where things stand today, what needs to be done. This book from a very well qualified person is a very real contribution. Her reform proposals are very useful both for Pakistan, and for all those donors – the US, the EU – who want to help ordinary Pakistanis. You do have access to healthcare in some of the rural areas, but if you go to places like Balochistan – which is the largest province and the most underdeveloped – you may have to travel for hours to get to the doctor. The situation is similar in the Federally Administered Tribal Areas (FATA) where suicide attacks are, unfortunately, routine. What they do is bring most of the injured to Peshawar, the capital of Khyber Pakhtunkhwa Province, which is at least two or three hours’ drive from the most troubled parts of FATA. It means that most people won’t make it to hospital alive, or very critical time will have been wasted. It is criminal that Pakistan has not invested in this sector. Apparently even international donors haven’t given much thought to supporting it."